【摘要】 目的探讨经食道超声心动图(TEE)检测非瓣膜性心房颤动(房颤)左心耳的大小、功能及与左心耳内血栓形成之间的关系,为临床进行风险评估、判断愈后及指导治疗等提供重要依据。方法采用 TEE 对41例非瓣膜性房颤伴或不伴高血压的患者进行左心耳检测,根据左心耳的形态特点,测量出左心耳入口的宽度(d)、左心耳顶部到入口的长度(L),用描记法测出左心耳舒张末期容积(EDV),运用脉冲多普勒测左心耳血流充盈与排空速度,检测左心耳内透声情况及有无血栓。结果41例房颤患者中左心耳血栓7例(17%),有血栓组与无血栓组的左心耳的大小、容积差异无统计学意义,而左心耳的峰值血流排空速度差异具有统计学意义[(0.52±0.19)m/s 与(0.32±O.69)m/s,P<0.01)];随房颤病程变化,左心耳容积变化具有显著差异[(6.5±1.8)m/s 与(8.5±1.0)m/s,P<0.01];房颤伴高血压组与不伴高血压组间上述指标差异也具有统计学意义[(6.9±2.2)m/s 与(7.5±1.2)m/s,P<0.05]。结论左心耳大小、形态的改变,功能的减低,血流速度的减慢是房颤患者左心耳内血栓形成的重要危险因素,检测左心耳大小、形态及功能对帮助临床进行风险评估、判断愈后及指导治疗等方面有重要的临床价值。更多还原

【Abstract】 Objective To explore the relationship between size,shape and function of the left atrium appendage (LAA) and its thrombosis in patients with atrial fibrillation (AF) by transesophageal echocardiography (TEE) to provide evidence for clinical risk assessment,prognosis evaluation and treatment guidance.Method Length,diameter,end-diastolic volume (EDV) and ejection velocity (PEV) of LAA were measured in 41 patients with AF,and thrombus in LAA was detected by TEE.Results Thrombus in LAA was detected in seven of 41 patients of AF (17%).No significant difference in size and EDV was found between the patients with and without thrombus,but there was significant difference in PEV between them (P<0.01).All the patients with AF were divided into six groups according to course of AF hypertension or thrombosis.As compared to the control group,every index was statistically significant higher in all patients with AF,and there was statistically significant difference in all indices between the patients with and without hypertension (P<0.05).There was significant difference in PEV and ejection fraction (EF) of the LAA between the patients with and without thrombus (P<0.05).Conclusions Decreased blood velocity and changes of volume was important risk factors for thrombosis in the patients with AF.It is important to make TEE in patients with nonvalvulor Af to help assessing clinic risk and prognosis.更多还原